After the molluscum bumps have resolved, persistent skin discoloration called hyperpigmentation may be left alone and allowed to resolve over time. Alternatively, residual hyperpigmentation may be treated with prescription fading creams like hydroquinone 4%, kojic acid, or azelaic acid 15-20%. Over the counter fading creams with 2% hydroquinone may be available like Porcelana. Specially designed prescription creams for particularly resistant skin discoloration using higher concentrations of hydroquinone 6%, 8%, or 10% with a retinoid and a topical steroid may also be formulated by compounding pharmacists. Mild chemical peels and microdemabrasion may also help improve discoloration.
Various laboratory methods, including vasoconstrictor assays, are used to compare and predict potencies and/or clinical efficacies of the topical corticosteroids. There is some evidence to suggest that a recognizable correlation exists between vasoconstrictor potency and therapeutic efficacy in man. Corticosteroids with anti-inflammatory activity may stabilize cellular and lysosomal membranes. There is also the suggestion that the effect on the membranes of lysosomes prevents the release of proteolytic enzymes and, thus, plays a part in reducing inflammation .
A common mistake is to be too cautious about topical steroids. Some parents undertreat their children's eczema because of an unfounded fear of topical steroids. They may not apply the steroid as often as prescribed, or at the strength needed to clear the flare-up. This may actually lead to using more steroid in the long term, as the inflamed skin may never completely clear. So, you may end up applying a topical steroid on and off (perhaps every few days) for quite some time. The child may be distressed or uncomfortable for this period if the inflammation does not clear properly. A flare-up is more likely to clear fully if topical steroids are used correctly.